Is TURP Surgery?

TURP, short for Trans Urethral Resection Prostate. The iatrogenic water poisoning that occurs during TURP surgery is called TURP syndrome.

TURP syndrome

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TURP, short for Trans Urethral Resection Prostate. The iatrogenic water poisoning that occurs during TURP surgery is called TURP syndrome.

TCM disease name

Transurethral resection of prostate

English name

Trans Urethral Resection Prostate

Common symptoms

Symptoms of cerebral edema such as disturbance of consciousness, nausea and vomiting, headache, blurred vision, shortness of breath

Contagious

Non-contagious

Origin of the name of TURP syndrome: TURP is the abbreviation of Trans Urethral Resection Prostate. Some people refer to the iatrogenic water poisoning that occurs during TURP surgery as TURP syndrome. The symptoms of water poisoning include irritability, retching, muscle twitching and tremor.

TURP usually occurs during or within hours of surgery, and it manifests itself as:

(1) The initial manifestations are high blood pressure (both systolic and diastolic blood pressure are increased), central venous pressure is increased and bradycardia, and blood pressure is decreased in the later period.

(2) Awake patients have symptoms such as irritability, disturbance of consciousness, nausea and vomiting, headache, blurred vision, shortness of breath and other symptoms of cerebral edema.

(3) Dyspnea, shortness of breath, and cyanosis hypoxia occur in pulmonary edema.

(4) Renal edema can cause oliguria or anuria.

(5) Blood sodium is reduced, which is an important diagnostic indicator. When the blood sodium drops to 120mmol / L, it shows irritability and delirium. Convulsions and loss of sensation, shock, and even cardiac arrest can cause death below 110 mmol / L.

It is very important to take treatment measures in time to make the patient turn into danger. Once the TURP syndrome is suspected, in addition to measuring the electrolyte in time and understanding the blood sodium level, the following treatment measures should be taken immediately.

(1) Intravenous diuretics, such as furosemide 40 mg, can be repeated after a few hours to promote the excretion of a large amount of water and restore normal blood volume.

(2) Intravenous injection of 3% to 5% of sodium chloride 250 to 500 ml, slowly infusion. At the same time, the situation of pulmonary edema should be closely monitored, and then sodium chloride should be used according to the blood sodium concentration.

(3) Inhale O2 to correct hypoxia.

(4) Use digitalis as appropriate to increase myocardial contractility.

(5) Cerebral edema, which should be treated with dehydration and intravenous dexamethasone, can help reduce intracranial pressure and reduce cerebral edema.

(6) The use of antibiotics that have no obvious damage to renal function to prevent infection.

The key to the prevention of TURP syndrome is to reduce the excessive absorption of irrigation fluid, use low pressure perfusion, control the irrigation fluid pressure below 40 cm of water column, often empty the bladder, prevent excessive filling of the bladder, avoid perforation of the prostate membrane and cut the sinus, End surgery as soon as possible.